Ohno Yoshiharu, Hatabu Hiroto, Takenaka Daisuke, Uematsu Hidemasa, Ohbayashi Chiho, Higashino Takanori, Nogami Munenobu, Yoshimura Masahiro, Fujii Masahiko, Sugimura Kazuro
Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Eur J Radiol. 2004 Nov;52(2):144-50. doi: 10.1016/j.ejrad.2004.01.015.
To determine the utility of dynamic magnetic resonance imaging (MRI) in the differential subtyping of small adenocarcinomas of the lung.
Twenty-nine pathologically diagnosed peripheral adenocarcinomas (less than 20 mm in diameter) underwent dynamic contrast-enhanced MRI. Maximum relative enhancement ratio, slope of enhancement, and corrected start time of enhancement were calculated from signal intensity-time curve of pulmonary lesion for each subject, and were statistically compared among bronchioloalveolar carcinoma (BAC) group (7 cases), mixed BAC group (10 cases), and adenocarcinoma group (12 cases).
Maximum relative enhancement ratio (P<0.001) and slope of enhancement (P<0.001) of BAC group were significantly higher than those of mixed BAC and adenocarcinoma groups. Start times of BAC group were significantly earlier than those of mixed BAC (P=0.0001) and adenocarcinoma groups (P<0.0001). Adapting the thresholds values of MR indexes from the positive tests, sensitivity, specificity, positive predictive value, negative predictive value and accuracy for differentiating BAC from other subtypes were 85.7, 100.0, 100.0, 95.7, and 96.6%, respectively.
Dynamic MRI is useful for differentiating subtypes of small peripheral adenocarcinoma.
确定动态磁共振成像（MRI）在肺小腺癌鉴别亚型中的应用价值。
对29例经病理诊断的外周型腺癌（直径小于20mm）进行动态对比增强MRI检查。根据每个受试者肺部病变的信号强度-时间曲线计算最大相对增强率、增强斜率和校正增强起始时间，并在细支气管肺泡癌（BAC）组（7例）、混合性BAC组（10例）和腺癌组（12例）之间进行统计学比较。
BAC组的最大相对增强率（P<0.001）和增强斜率（P<0.001）显著高于混合性BAC组和腺癌组。BAC组的起始时间显著早于混合性BAC组（P=0.0001）和腺癌组（P<0.0001）。根据阳性试验的MR指标阈值，鉴别BAC与其他亚型的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为85.7%、100.0%）、100.0%、95.7%和96.6%。
动态MRI有助于鉴别小外周腺癌的亚型。
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